Acupuncture Society Auto-renew Subscription Payment Form
Please fill in all required form fields below, you will be then taken to PayPal to make an appropriate annual auto-renew subscription for your Acupuncture Society membership. You will need a PayPal account to be able to set this up.
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First Name
Last Name
Email
*
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Phone Number
*
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Area Code
Phone Number
Date
*
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Day
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Month
Year
Date
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Please Only Click 1 of the Below Payment Options
to avoid being accidentally overcharged
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Acupuncture Practitioner Auto-renew Subscription
£
100.00
Bodyworker Practitioner only Auto-renew Subscription
£
50.00
Acupuncture and Herbal Practitioner only Auto-renew Subscription
£
100.00
Acupuncture and Herbal Practitioner & Bodyworker Auto-renew Subscription
£
100.00
Herbal Practitioner only Auto-renew Subscription
£
100.00
Total
£
0.00
Pay with PayPal
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Last Name
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Card Expiration
Please click one of the PayPal options to complete payment and
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the form.
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